Allows healthcare data to be captured and provided any where and any time Healthcare data on mobile devices is healthcare data on the move The term is most commonly used in reference to using mobile communication devices, such as mobile phones and PDAs, for health services and information
Himss 2012 youtube video
Personal Health Records can be web based or app based records. If I use an app to record what I eat, how much I weigh etc… that app becomes my personal health record. Many personal health records do not connect with Electronic Health Records because that requires more complex and expensive back end development
PHR youtube video
An electronic health record is a collection of patient health information generated by one or more meetings in any care delivery setting. An EHR typically includes patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. It’s said to streamline clinicians’ workflow, and it has the ability to generate a complete record of a clinical patient encounter. EHRs focus on the total health of the patient. They go beyond standard clinical data collected in the provider’s office and include a broader view of the patient’s care. EHRs are designed to reach beyond the health organization that originally collected the data and are built to share information with other providers. EHRs’ most notable benefit include a secure sharing of data, which, in turn, results in more open communication and more involvement on the patient’s part. http://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/
YouTube video -
We connect through a screen wherever we are. That can include a desktop, a laptop, tablet, Smart Phone, device etc.. An electronic health record (EHR) is built to share information with other health care providers, such as laboratories and specialists. They contain information from all the clinicians involved in the patient’s care and authorized clinicians can access the information they need, to provide care to that patient. A personal health record (PHR) contains the same types of information as a electronic health record—diagnoses, medications, immunizations, family medical history, and contact information for providers—but it is designed to be set up and accessed by patients themselves.
Who are the biggest users of mobile health? Men are slightly higher users The majority of mobile health users have a Smartphone Over half have downloaded a health related app 30% of app users have uninstalled an app because they learned it was collecting personal information that they did not wish to share. An important point to note is that 85% use social media for health
The good news is that 15 percent of younger cell phone users (18-29) and urban African-American users had health apps on their phone, at least in September 2010, according to a Pew report from November 2011. But that also meant that only 8 percent of cell phone users aged 30-49 -- ages at which health issues are more likely to arise -- downloaded mobile health apps. What mhealth does is encourage and provide a means for engagement of the patient to be involved with their health.
Mobile devices offer remarkably attractive low-cost, real-time ways to assess disease, movement, images, behavior, social interactions, environmental toxins, metabolites and a host of other physiological variables. Many mHealth technologies could be put to highly innovative uses in biomedical research; at the same time, biomedical research could help build the foundation of evidence that so many mHealth applications currently lack.
What is the recipe for a good mobile app?
A Text Message–Based Intervention for Weight Loss: Randomized Controlled Trial Kevin Patrick 1 , MD, MS; Fred Raab 1 ; Marc A Adams 1,2 , MPH; Lindsay Dillon 1 , MPH; Marian Zabinski, PhD; Cheryl L Rock 1 , PhD, RD; William G Griswold 3 , PhD; Gregory J Norman 1 , PhD 1 Department of Family and Preventive Medicine and the California Institute of Telecommunications and Information Technology (Calit2), University of California, San Diego, La Jolla, CA, USA 2 Graduate School of Public Health, San Diego State University, San Diego, CA, USA 3 Department of Computer Sciences and Engineering, University of California, San Diego, La Jolla, CA, USA Corresponding Author: Kevin Patrick, MD, MS Department of Family and Preventive Medicine and California Institute of Telecommunications and Information Technology (Calit2) University of California, San Diego 9500 Gilman Drive, DEPT 0811 La Jolla, CA 92093-0811 USA Phone: +1 858 534 9550 Fax: +1 858 534 9404 Email: kpatrick [at] ucsd.edu
This is where I will toggle back and forth a live view of RD’s texting in a keyword such as txt to a shortcode.
In May, through a study Katz began with nearby Howard University Hospital's diabetes clinic, Harvey received a Web-based personal health record that he clicks onto using his cell phone, to record his daily blood sugar measurements. If Harvey enters a reading higher or lower than preset danger thresholds, a text message automatically pings a warning, telling him what to do. And at checkups, doctors will use the personal health record, created by Indiana-based NoMoreClipboard.com, to track all his fluctuations and decide what next steps to advise.
Talk about weakness of client entering data versus device driven data but provide overview of how the system works with data input driving rules for messaging etc…
Talk about data driven conversations.
http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/ClassifyYourDevice/ucm051512.htm Review the differences and advantages of devices over apps The FDA’s guidelines do not indicate that every health-related app will require FDA approval. For instance, a calorie-counting or healthy-eating app may not need approval from the FDA. Only true “medical apps”, where inaccuracies or bugs could cause great economic and personal loss, would need to seek FDA approval to be sold. An example of a medical app is an ECG regulator used by doctors in hospitals or remotely by patients at home. The new regulation process is consistent with the FDA’s current medical software regulations and would liken itself to pre-existing medical device regulation protocols.
This should take about 15 for individual group sharing and discussion- another 15 minutes could be used to share with the entire group. Total 15-30 minutes.
Provide a brief overview of where the data is entered and how it flows from patient to provide etc…
Fitness Apps are for those who want to get in shape or who are training for an event (marathon) Wellness Apps are for those who want to live healthy lifestyles through diet and exercise Medical or Healthcare Apps are for professionals managing their work or for patients to deal with a specific health condition – implies the requirement for FDA regulation.
While the term "consumer health IT applications" is not yet well-defined, in general, it refers to a wide range of hardware, software, and Web-based applications that allows patients to participate in their own health care via electronic means. The American Medical Informatics Association (AMIA) has developed a working definition for the field of consumer health informatics stating that it is "a subspecialty of medical informatics which studies from a patient/consumer perspective the use of electronic information and communication to improve medical outcomes and the health care decision-making process."  In addition, as defined by Eysenbach, the study of consumer health informatics includes analyzing consumers' information needs, studying and implementing methods of making information accessible to consumers, and modeling and integrating consumers' preferences into medical information systems. 
Encourage participants to visit the Academy website for up to date reviews and information on popular apps.
LoseIt! (free) . Helps motivate dieters by allowing them to set and log their daily caloric intake by doing such things as scanning the bar codes of foods they eat. Withings WiFi Scale ($159 for the scale; the app is free) . Monitors your weight, BMI, body fat percentage and other health data when used with the associated wireless scale. iBGStar Diabetes Manager ($75 for the meter; the app is free) . Track your blood glucose levels and insulin usage and share information and trends with your health-care team with this app and its iPhone-enabled glucose meter.
FDA approval affect the cost and the timeliness of apps entering the market. There is already a short time frame for the life of many health related apps-
Confused about Nutrition and Technology?Don’t Worry. Be Appy.Nadine Fisher MS, RD/LD
Potential Learning Need Codes:(1000) Professional skills(1020) Computer, electronic technology(1090) Media skills(1110) Risk-taking(1140) Written communication skills,publishing(6000) Education, Training, and Counseling(7000) Business and Management(7040) Consultation(7050) Customer Focus(7070) Entrepreneurship, private practice(7120) Marketing
Objectives• Discuss the importance and role of mobile health apps to improve patient outcomes.• Describe the importance and the relationship between mobile apps and data collection related to patient health record and EHR including delivery to their healthcare providers.• Describe the development process from concept to app for both the private and public sectors.
What is Mobile Health (mHealth)?• mHealth (also written as m-health or mobile health) is a term used for the practice of medicine and public health, supported by mobile devices. (Wikipedia 2012)
Personal Health Record = PHR • A personal health record (PHR) contains data maintained by the patient.
Electronic Health/Medical Record • EMR’s are digital version of chart. • EMR contain medical and treatment history of one practice. • EHRs may include a range of data ( from multiple providers) with focus on total health of the patient.
mHealth Users• Pew Internet and American Life Project: While 88% of Americans have a cell phone, only 10% have downloaded health-related mobile apps.
Why is mHealth Important?• Empowers Client to Manage their Health• Care Coordination Opportunities• Immediate Exchange of Accurate Objective Information from Client to Provider• Earlier and More Accurate Diagnosis• Remote Monitoring Opportunities
Medical App Essentials• Personalization• Cloud based connection• Interface with EHR/PHR• Disease management, education & messaging• Social support engagement (Social Media)• Adheres to evidence based practices• Secure system for collecting and transmitting health information
TechnologyMotivates• A 2009 study found that people who received personalized text messages about weight control and other health issues two to five times a day dropped more pounds over a four-month period than those who received printed materials in the mail.
RD Poll – Text to Screen How many of you are currently using a mobile technology such as text messaging in your practice? TEXT FNCE to 55678.
How Mobile Health Applications Work• Tyrone Harvey, 43, diagnosed with diabetes in 2005 after 7 day hospitalization, struggles with blood sugar maintenance.• Harvey participates in study and enters Blood Sugar Data into a web based PHR using cell phone.
Activity: Apply the Mobile Health Concept• Take a few minutes to consider how you might apply a mobile health concept to your current practice or to any practice.• Share your ideas with your neighbor ( anyone seated in your immediate area).• Discuss in groups of 2-4 what the advantages would be, disadvantages, challenges and barriers.
Which app/device?• Popular today… – LoseIt! (free). Helps motivate dieters by allowing them to set and log their daily caloric intake using bar code scanning technology. – Withings WiFi Scale ($159 for the scale; the app is free). Monitors weight, BMI, body fat percentage and other health data when used with the wireless scale. – iBGStar Diabetes Manager ($75 for the meter; the app is free). Tracks blood glucose levels and insulin use. Share information and trends with health-care team using iPhone-enabled glucose meter.
Current & Future Challenges• FDA Approval• Device versus App• Cost of Device/App Development• Client Compliance• Maintaining Privacy and Security of Health Data
Conclusion• Mobile Technology has changed the way consumers and health care providers access health related information.• Mobile health is an exploding field that encompasses all areas of health care through the use of mobile devices and smart phones.• Health Care Professionals need to be familiar with the current technologies (including social media and health related apps), used by their patients.
Resources• FDA Guidance on Medical Devices and Apps• Fierce Mobile Healthcare• iMedicalApps• Manhattan Research Cybercitizen Health Survey• mHimss• Mobi Health News• Pew Internet Research• Happtique
Thanks for Your Attention!• Follow me: @nadinekf• Learn more about Social Media: www.facebook.com/SocialRD• Review my Apps: www.nadinefisher.com